I had an unfortunate run-in with a pair of nursing staff looking after a specific patient the other day. The patient has severe respiratory compromise associated with consolidation and had low levels of saturation- of which physiotherapy was indicated. Initially, I tried to discuss with the patients nurses when the most appropriate time would be for me to come and assess and treat their patient. This took several attempts due to the fact that the nurse continually ignored my questions and walked away from me several times. After persevering with a nice smile and patience, eventually I was given the ‘ok’ to continue. Between my assessment and treatment, where I had to consult with the supervisor as to my treatment plan etc. the nursing staff had turned the patient from the position I wanted to treat, onto their other side (draining the clear lung and with the clogged up lung on the bottom). Given the patient had been turned and secretions potentially mobilised I had to reassess again and finally treat. After the supervisor and I were happy with the results from treatment, we left the patient. Whilst writing up their notes I was abruptly interrupted by one of the nurses who walked up to me and said ‘You’ve broken the patient’ and just as abruptly walked off. I had a giggle to what happened, and went over to see the patient to make sure things were ok. Consequently the nurse was consecutively suctioning the patient 3-4 times in a row, without any sputum being brought up and without preoxygenating the patient and worried that he was dropping to 85%. Once they’d stabilised I continued writing the notes and overheard the nurse telling the other nurse what had happened, and not so obviously pointing out that it was after physio… I then again got another interruption from the second nurse talking loudly to me to “come listen to what you’ve done”. Going into the patients room and having these two nurses staring me down, I continued to listen to the patients chest (of whom they’d since moved him onto his back now- ie. Remobilised his chest which I nicely explained to them). Anyway his chest sounded fairly clear, which the nurse double-checked with his stethoscope and consequently huffed about the wheeze having disappeared.
After this incident I discussed it with the supervisor and we decided it was just something that should be laughed off, and that the patient had desaturated distinctly 5-10 mins after our treatment and that occasionally blame is passed onto students by some staff members more than others. Since this incident, I don’t feel like I’ve needed to change how to deal with the situation but am reassured that it is important to tell supervisors these things, even if you may consider then banal, so as to ensure they are aware as to any discrimination that may occur during your placement.
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2 comments:
That's a really hard position to be put in- I definetly admire your ability to laugh it off! In my experiences of these type of situations, Ive often found it hard not to feel like a nuisance, useless student at the time, and afterwards going away to think about it knowing that I should have had the confidence to believe in myself and what I was doing.
I think its really important that we educate not only our patients on our treatments, but also the nursing staff. While some nurses who have been around for a while can be very stuck in their ways and their beliefs of what is good for the patient, at least educating them from a physio point of view might help to ease these types of situations.
I have also had a few incidences with nurses over the past who feel like students get in the way alot and make their lives difficult. One in particular was so difficult, and whenever I went in to see the patient she would say that she was busy with them and I had to come back. So one day I asked her what it was she was doing with them, and she said she wanted to get them into the shower. So i asked her whether she would like me to do that for her, as part of my treatment. She actually looked a bit suprised, but agreed. So I was able to assess my patients mobility, check their chest and oxygen levels while walking, and help the nurse out too. After that things were ok.
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